April 2017 Surgery

Hi, Hope88 -

I'm sorry you will need two surgeries. I too will most likely have my surgery in April (finished last chemo for triple positive on March 2.) I see the general surgeon tomorrow. I'm having a bilateral mastectomy with immediate reconstruction. I'm sort of freaking out because my friend at work told me today about someone who had a really bad time with the plastic surgeon who worked with my general surgeon at the time (infection, he didn't listen to her when she said something was wrong, etc.), so I'm trying to find out if it is the same plastic surgeon who is doing my reconstruction. I've had several surgeries by the general surgeon, and he is wonderful, so I know I definitely want him to do the mastectomy. I don't know what I'll do if the plastic surgeon is the same one she had problems with. It could turn out that it was an isolated incident, but it still makes me nervous. I really don't think my surgeon would work with an incompetent plastic surgeon. I met the plastic surgeon last week and he was a character, but I liked him.

So there's my venting! I wish you the best with everything.

Hi All,

I was hoping someone would start an April surgery group. Thank you Hope88.

I have surgery scheduled for April 26. I finished Chemo on March 13. I guess one has a 4-6 week window for surgery. Four weeks is in the middle of spring break for my child and we had scheduled a vacation (back before I knew I had cancer). I told the surgeon I could skip Moab and make the vacation shorter (so I could be home the whole previous week). She said "You don't want to miss Moab, we'll schedule for the last week of April." So I'm really excited to be able to go on vacation with my family right before surgery. When I had my treatment plan day back in November, the nurse said, don't cancel, things just might work out with the timing.

So right now I'm scheduled for a right mastectomy with a tissue extender to leave me some options. I just found out yesterday from the latest plastic surgeon, that he says I don't have enough belly for even one Diep procedure, which is why I scheduled just for the right breast. Another one said I might have enough, but looking at the lines he drew on my belly, I couldn't see how that would work. I don't have any belly rolls and if the surgeon took that much tissue, I would be bending over. So I agree with this latest surgeon. And I can't get the surgery that uses the inner thigh, not enough fat. I won't do the surgery that uses the butt (too extensive). So I found out yesterday the only autologous surgery available to me is Lat. Dorsi. I don't think I want to take away my back muscles.

I've got to say that I'm really angry at my lack of options, when others have the body type to get those options. I consider myself fat, (I need to lose another 20 lbs), but the plastic surgeon doesn't think I'm fat even though I have an overweight BMI. I have lots of muscle, so where other people have a little muscle and enough fat on their inner thighs or belly, I have lots of muscle and a little fat. I have lots of fat on my outer thigh, but that is not a place they take tissue from.

I won't know if I will have radiation on my breast until after surgery/pathology, so I decided to do the tissue extender to give me the option of an implant. Or I could just remove the TE and and get a prothesis, which I might do. I'm starting to get comfortable with the idea of a prothesis, but putting in the tissue extender gives me an option which does not require me to take my back muscles away. I will definitely have radiation on my lymph nodes.

Sorry to be so long winded. Since I just heard that I couldn't have Diep yesterday, I'm still reeling from that. But celebrating that my family can go on vacation to southern Utah

Ha ha Hope! Don't feel bad...I just live far away from a lot of things....I have to drive 25 min for my chemos and the closest hospital too...

I'm a teacher and I"m not sure if I'll be in school when radiation starts, I might be....I know my RO said I can't start rads until my expanders are totally full....so I'm not sure how long after surgery that takes? I'm hoping I can start rads in June sometime and only go into my summer vacation a few weeks (so I get to enjoy it and not be driving 2 hours a day instead ugh) so we'll see....

Hangingin sorry you can't get the surgery you were hoping for...I'm sure I probably have enough fat for those surgeries LOL but my MO and RO both agreed that implants were the best way to go...they felt that they get the best results (long term) from them opposed to using your own body fat etc....and I"m ok with that, since I really don't want a bigger, longer, more detailed surgery anyway LOL (I've never had surgery before so Im a little nervous to begin with)

I will be having my surgery on April 10th. I just called the plastic surgeon's office to ask about what type of implant they ordered for me since the report about textured implants and a rare form of lymphoma associated with them just came out. They are texting the plastic surgeon to find out whether it's textured or not. One story I read said that they found most cases involved Alergan brand implants. The brand they ordered for me is Sientra. I know that the chances are low to develop the lymphoma, but I would decrease the chances more by having a smooth implant.

Wow BG46TN, I just saw you started following the March surgery group in February. You are so smart and good at planning ahead. I just today thought of reading that group. I wish I could see further than the nose on my face when it comes to breast cancer. I had to be through with chemo to even start thinking about surgery.

Figured I would join you guys. My exchange surgery is scheduled for April 10th.

Can someone tell me what exchange surgery is? I'm new to the whole surgery thing and only recently considered implants. I'm getting unilateral mastectomy with tissue extender and from there I will decide what to do. (Take it out and go with prosthesis or get implant)

I think I'm in panic mode right now! I have a very aggressive (100% replicity) and triple negative breast cancer that seems to be localized to my left breast. I just completed (as much as I could do) 5 months of chemotherapy. We tried to get a last session in on March 17th and my blood counts and platelets were still too low so they called chemo. My projected surgery date was April 20th but they moved it up to April 6th since the date of my last chemo changed. I was given a choice of lumpectomy and radiation or a mastectomy. I chose a bilateral mastectomy without reconstruction because I am fearful of radiation. My cancer is on the left breast and I am fearful of the residual radiation into the heart and lungs. I am 65, have no heart problems, but have asymptomatic emphysema in all 5 lobes of my lungs. I have no breathing problems and this was found quite by accident but the problem is the radiation can change my lack of symptoms. Now I am rethinking my decision - thus, my panic mode. Lumpectomy is less invasive, I could still have radiation with the mastectomy, should I just have my left breast removed and not my right? (I have a friend who had 1 breast removed and hates the "off balance" feeling she has even with the prosthesis.) I have researched all my options, talked to breast cancer survivors who have been through this, and consulted with doctors. This week I will meet with another radiation oncologist. It seems everyone I talk to says get the mastectomy, be done with it, and you won't live with the fear of radiation. If I talk to a doctor, however, none of them will validate or negate my concerns; none of them will help me make the choice. Obviously, I have trouble making decisions. To add to all of this, my 4.1 cm tumor disappeared during chemo, which is a good thing, but they did find an area of cancer in a breast MRI last week. Yesterday I found a new lump in the same quadrant but still a different area. It's only about the size of a grape, but it is definitely there! I will see my doctor Tuesday - apparently this is not a surprise because of how fast growing this cancer is. (My original tumor grew from 2.3 cm to 4.1 cm in 3 weeks.)

I know I can't ask any of you to make my decision for me but as you are the ones living this right now so I thought maybe you could offer some words of wisdom.

Wishing you all the best and I will be sending positive thoughts and energy your way as you progress in your battle to win, too!

warrior2016. I did neo-adjuvant chemo as well. I decided on a bi-lateral mastectomy thinking I could avoid radiation. My pathology came back showing very little tumor left and inactive but some residual DCIS was found. Because of that and the original location of my tumor being very close to the chest wall it was highly recommended to do radiation. I know it is scary when it is your left side but my RO explained in detail the very minimal scatter radiation to hit the heart or upper lungs if they get the angles right. She even showed me the paths of radiation after all my mapping was done. It had been 31/2 years and I am feeling great.

Good luck with your decisions.

Thank you jbdayton, I'll look at those websites. But when the surgeon drew on my belly after 2 days I didn't think I could have that much tissue removed and be comfortable with it. I would post a picture of my belly, but I'm not sure I want pics of my belly online. The marks go from above my belly button to just above my pubic hair. There are no rolls and he would be taking my skin with a thin layer of fat under it. (I have small breasts, so it is not like he is creating a C or D cup.

I had a 7 mm invasive ducal carcinoma diagnosed on 12/5, and had the option of a lumpectomy and radiation, but decided on BMX. My mother had BC twice, and although the chance of my developing BC in the other breast was low, I decided against the lumpectomy. I'm 66, and was a 40G, and the surgeon recommended against a mastectomy of just the affected breast, and I agreed. I read a lot of blogs, and the people who seemed to complain the most were the ones with prosthetics, complaining mostly about the heat. Since I live in Texas, that resonated with me. I had my BMX with tissue expander on 3/8, and went home the next day. I haven't had any pain that was unbearable, and haven't taken any pain meds during the day since the first week. I still take a pill before I go to sleep, because it's uncomfortable enough added to the fact that I have to sleep on my back that I can't get to sleep without it.

My PS wanted to do tissue expanders and use the latissimus dorsi, but I didn't want to do that, so he agreed to just implants. He said the lat tissue was needed for a satisfactory result, but I had considered no reconstruction at all, and I'm not at a place in my life where perfect looking breasts are important to me. In fact, I'm just glad to get rid of the dents on my shoulders, and neck pain that accompany breasts the size mine were.

Unless I have misunderstood something, I don't have to have radiation like some of you. I go to the MO tomorrow and will find out what else I might have to do.

Warrior, having two parents and an in-law that died due to complications from emphysema and COPD, I would avoid the radiation as well if it could cause problems with your emphysema

Hi Hope88.

I could do Lat. Dorsi, but I don't want to give my back muscles for the sake of a breast. My other choice is GAP (butt) http://www.breastcancer.org/treatment/surgery/reco...

This comparison shows the GAP flap, which is the butt, 9-12 hours: This is the caution about the surgery:

"Long operation with risk of more complications; higher risk of tissue breakdown; can be done only by a plastic surgeon skilled in microsurgery techniques; can cause fat necrosis; could delay radiation and chemotherapy; usually causes some pain and discomfort while sitting "

They do one butt cheek at a time (most places) and then you have more surgery. It seems too risky for me.

But I do have enough fat there.

I think it is all about how much you want breast recon and how much risk and surgery you are willing to put up with.

BG46TN, did you ask your PS about the implants? I'm curious what their opinion is about the study. I'm still agonizing over whether I want to take the risk with implants. I know the worst thing to do is Google, but there are so many articles with conflicting information, I don't know what to think!

Hi, buffyjc! What type of surgery are you having? We'll only be two days apart. I keep Ativan on hand for when I start feeling I'm jumping out of my skin, but luckily haven't had to take it too often!